Anti-tumour necrosis factor α treatment in chronic recurrent inflammation of the anterior segment of the eye in patients resistant to standard immunomodulatory treatment

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Abstract
Nine patients with uveitis with associated systemic disease were included (table 1). Eight of these patients had a rheumatic disease (five had a spondyloarthropathy (all were HLA-B27 positive), two had juvenile idiopathic arthritis (JIA; one Still’s disease, one antinuclear antibody (ANA) positive oligoarthritis)) and one patient had a necrotising sclero-uveitis associated with Wegener’s granulomatosis. One patient with uveitis with an associated tubulointerstitial nephritis (TINU) was also included. Disease modifying antirheumatic drug (DMARD) treatment was started at least three months before infliximab treatment. It consisted of methotrexate (MTX) in seven patients, of whom two received a combination of MTX and mycophenolate-mofetil. One patient received cyclophosphamide, and one leflunomide. Because the response was inadequate towards even combined immunosuppressant treatment (for example, MTX plus mycophenolate-mofetil) or because of the massive destructive activity of the disease (for example, necrotising sclero-uveitis) a quick acting active anti-inflammatory substance was needed. Because a quick response towards infliximab had been seen in a previous study, it was chosen again.3

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